Featured Research

Trauma center closures linked to higher odds of death for injured patients

Date:

March 13, 2014

Source:

University of California, San Francisco (UCSF)

Summary:

Injured patients who live near trauma centers that have closed have higher odds of dying once they reach a hospital, according to a new analysis. Trauma centers are specially staffed and equipped to provide care to severely injured people. They can be costly to operate and many centers struggle to keep their doors open. During the last two decades, about a third of the United States' 1,125 trauma centers have shut down.

Related Articles

Trauma centers are specially staffed and equipped to provide care to severely injured people. They can be costly to operate and many centers struggle to keep their doors open. During the last two decades, about a third of the nation's 1,125 trauma centers have shut down.

The new study, involving more than a quarter of a million patients, analyzed the impact of closures of three centers in California. It found that when a trauma center shut its doors, injured patients who had to travel farther to reach an open trauma center had 21% higher odds of in-hospital death than injured patients who did not have to travel farther for trauma care. The odds of death were even higher -- 29% -- during the first two years after a closure, the authors reported.

"This study confirms that when trauma centers close, people who live in the surrounding areas are more likely to die following an injury," said lead author Renee Y. Hsia, MD, an associate professor of emergency medicine at UCSF. She is also an attending physician in the emergency department at the UCSF-affiliated San Francisco General Hospital & Trauma Center and a faculty member of the UCSF Institute for Health Policy Studies.

"There have been an increasing number of trauma center closures in recent years, and these closures are associated with a higher risk of death in the affected communities," she said.

The article will be published March 13, 2014 in The Journal of Trauma and Acute Care Surgery.

Researchers compared patients whose travel time to their nearest trauma center increased to those with no change in travel time, as well as those whose travel time to trauma care decreased after a trauma center opened nearby. They found that decreased travel time to the closest trauma center was associated with 17% lower odds of in-hospital mortality compared to the group experiencing no change, while increased travel time was associated with 14% higher odds of in-hospital mortality.

These effects were intensified in the first two years following a closure. Injured patients with decreased travel times to the nearest trauma center had 16% lower odds of death, while injured patients affected by a closure had 26% higher odds of death.

The researchers examined the impact of three trauma center closures in California between 1999 and 2009 on more than 270,000 patients with injuries admitted to their nearest trauma center. They compared the in-hospital mortality of 5,122 patients, who lived in ZIP codes where their drive time to that nearest trauma center increased as the result of a nearby closure, to 228,236 patients whose drive time did not change, and 37,787 patients whose travel time decreased as the result of a trauma center opening.

Affected patients were more likely to be young and low income, to identify as part of a racial or ethnic minority group and have Medi-Cal insurance than patients whose travel time to their nearest trauma center did not increase, Hsia said.

University of California, San Francisco (UCSF). "Trauma center closures linked to higher odds of death for injured patients." ScienceDaily. ScienceDaily, 13 March 2014. <www.sciencedaily.com/releases/2014/03/140313092047.htm>.

University of California, San Francisco (UCSF). (2014, March 13). Trauma center closures linked to higher odds of death for injured patients. ScienceDaily. Retrieved March 31, 2015 from www.sciencedaily.com/releases/2014/03/140313092047.htm

University of California, San Francisco (UCSF). "Trauma center closures linked to higher odds of death for injured patients." ScienceDaily. www.sciencedaily.com/releases/2014/03/140313092047.htm (accessed March 31, 2015).

Featured Research

Mar. 31, 2015  Researchers have illuminated an important distinction between mice and humans: how human livers heal. The difference centers on a protein called PPAR alpha which activates liver ... full story

Mar. 31, 2015  Researchers have recorded the first direct observations of the micro-scale mechanisms behind the ability of skin to resist tearing. The results could be applied to the improvement of artificial skin, ... full story

Mar. 31, 2015  Fewer than half of the physicians trained in the United States in 2013 received formal education or training on the subject of exercise, according to new research. "There are immense medical benefits ... full story

Mar. 31, 2015  Memory and as well as connections between brain cells were restored in mice with a model of Alzheimer's given an experimental cancer drug, researchers report. "With this treatment, cells under ... full story

Mar. 31, 2015  Increasing state alcohol taxes could prevent thousands of deaths a year from car crashes, say researchers, who found alcohol-related motor vehicle crashes decreased after taxes on beer, wine and ... full story

Mar. 31, 2015  Alcoholism takes a toll on every aspect of a person's life, including skin problems. Now, a new research report helps explain why this happens and what might be done to address it. "The clinical ... full story

Mar. 31, 2015  A new population of 'memory' immune cells has been discovered by scientists, throwing light on what the body does when it sees a microbe for the second time. This insight, and others like it, will ... full story

Mar. 31, 2015  Coronary heart disease and stroke, two of the leading causes of death in the United States, are diseases associated with heightened platelet reactivity. A new study in humans suggests an underlying ... full story

Mar. 31, 2015  A new study had researchers seeking answers to why the therapeutic benefit afforded by SSRIs was so limited in children and teenagers. If researchers can uncover the biological mechanisms preventing ... full story

Featured Videos

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015)  The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports.
Video provided by Reuters

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015)  Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline.
Video provided by Washington Post

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015)  Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17
Video provided by AFP

Related Stories

Sep. 22, 2014  Patients with severe injuries should be treated at level I or level II trauma centers, experts say. Those centers have the resources to provide the best care for those patients. But one out of three ... full story

Oct. 5, 2011  Closures of hospital trauma centers are disproportionately affecting poor, uninsured and African-American populations, and nearly a fourth of Americans are now forced to travel farther than they once ... full story

Jan. 17, 2011  A significant portion of the US population does not have access to trauma care within an hours' drive, with certain vulnerable groups at higher risk of worse access, according to a new ... full story

Nov. 2, 2010  Severely injured patients should be transported directly from the scene of an accident to a trauma center, even if it means bypassing a closer hospital, according to new research that shows this ... full story

ScienceDaily features breaking news and videos about the latest discoveries in health, technology, the environment, and more -- from major news services and leading universities, scientific journals, and research organizations.